<form id="form1" method="post" action="some_action" enctype="multipart/form-data" style="margin:10px;">
	<input type="hidden" name="kode" id="kode" value="<?=$kode?>">
	
				<div class="fitem" >
					<label style="width:120px">Kode Jadwal PMB </label>:
					<input name="PMBPeriodID" size="10" value="<?=$PMBPeriodID?>">
				</div>
				<div class="fitem" >
					<label style="width:120px">Universitas </label>:
					<select id="kd_pt" name="kd_pt" style="width:200px;">
						<?=$this->mdl_prosedur->OptionUniversitas(array('value'=>$kd_pt));?>
					</select>
				</div>
				<div class="fitem" >
					<label style="width:120px">Nama Jadwal PMB </label>:
					<input name="Nama" size="30" value="<?=$Nama?>">
				</div>
				<div class="fitem" >
					<label style="width:120px">Tanggal Mulai</label>:
					<input class="easyui-datebox" name="TglMulai" size="13" value="<?=$TglMulai?>" id="TglMulai" data-options="formatter:DateFormatter, parser:DateParser">
				<label> </label>
					<label style="width:130px">Tanggal Selesai</label>:
					<input class="easyui-datebox" name="TglSelesai" size="13" value="<?=$TglSelesai?>" id="TglSelesai" data-options="formatter:DateFormatter, parser:DateParser">
				</div>
				<div class="fitem" >
					<label style="width:120px">Tanggal Mulai Ujian</label>:
					<input class="easyui-datebox" name="UjianMulai" size="13" value="<?=$UjianMulai?>" id="UjianMulai" data-options="formatter:DateFormatter, parser:DateParser">
				<label> </label>
					<label style="width:130px">Tanggal Selesai Ujian</label>:
					<input class="easyui-datebox" name="UjianSelesai" size="13" value="<?=$UjianSelesai?>" id="UjianSelesai" data-options="formatter:DateFormatter, parser:DateParser">
				</div>
				<div class="fitem" >
					<label style="width:120px">Tanggal Mulai Bayar</label>:
					<input class="easyui-datebox" name="BayarMulai" size="13" value="<?=$BayarMulai?>" id="BayarMulai" data-options="formatter:DateFormatter, parser:DateParser">
				<label> </label>
					<label style="width:130px">Tanggal Selesai Bayar</label>:
					<input class="easyui-datebox" name="BayarSelesai" size="13" value="<?=$BayarSelesai?>" id="BayarSelesai" data-options="formatter:DateFormatter, parser:DateParser">
				</div>
				<div class="fitem" >
					<label style="width:120px" >Terapkan Pada Prodi</label>: 
					<table style="width:200px;margin-left:130px;">
						<tr><td><input type="checkbox" name="TelitiBayarProdi1" <?=$TelitiBayarProdi1=='Agribisnis'?'Checked="checked"':''?>/>&nbsp;Agribisnis</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi2" <?=$TelitiBayarProdi2=='Agro Eko Teknologi'?'Checked="checked"':''?>/>&nbsp;Agro Eko Teknologi</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi3" <?=$TelitiBayarProdi3=='Akutansi'?'Checked="checked"':''?>/>&nbsp;Akutansi</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi4" <?=$TelitiBayarProdi4=='Biologi'?'Checked="checked"':''?>/>&nbsp;Biologi</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi5" <?=$TelitiBayarProdi5=='Ekonomi Pembangunan'?'Checked="checked"':''?>/>&nbsp;Ekonomi Pembangunan</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi6" <?=$TelitiBayarProdi6=='Geologi'?'Checked="checked"':''?>/>&nbsp;Geologi</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi7" <?=$TelitiBayarProdi7=='Kehutanan'?'Checked="checked"':''?>/>&nbsp;Kehutanan</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi8" <?=$TelitiBayarProdi8=='Manejmen'?'Checked="checked"':''?>/>&nbsp;Manejmen</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi9" <?=$TelitiBayarProdi9=='Manejemen Sumberdaya Pesisir'?'Checked="checked"':''?>/>&nbsp;ManejemenSumberdaya Pesisir</td></tr>
						<tr><td><input type="checkbox" name="TelitiBayarProdi10" <?=$TelitiBayarProdi10=='Sistem Informasi'?'Checked="checked"':''?>/>&nbsp;Sistem Informasi</td></tr>
					</table>
				</div>
				<div class="fitem" >
					<label style="width:100px">Status</label>:		
					<input type="checkbox" name="status" <?=$status=='A'?'checked':''?>/> Aktif
				</div>
</form>

	

